Paper 17 - Royal United Hospital Bath NHS Trust

Report to: Public Trust Board Agenda item: 17 

Date of Meeting: 29 May 2013 

Title of Report: 

Status: 

Board Sponsor: 

Author: 

Appendices 

Chief Executive’s Report 

For Information 

James Scott, Chief Executive 

James Scott, Chief Executive 

1. Purpose of Report (Including link to objectives) 

The purpose of the Chief Executive‟s Report is to highlight key developments within 

the Trust which have taken place since the last Board meeting. 

2. Summary of Key Issues for Discussion 

2.1 Operational Performance 

The Urgent Care Task and Finish Group between providers and commissioners at 

Director level, has now engendered some momentum to addressing the demand and 

flow issues across the system. This will be critical preparation for the next winter in 17 

weeks time. The Intensive Support Team is shortly scheduled to undertake a whole 

system diagnostic. In addition to this, it has been formally agreed to enter into a 

simulation event with all stakeholders present, in order to better collectively 

understand the escalation triggers and associated actions needed. April performance 

is clearly disappointing and actions are being accelerated wherever possible. Weekly 

performance towards the latter part of the month and in to May are encouraging. 

2.2 Spring to Green Week 

Spring to Green week took place between 13 th – 18 th May 2013 and was designed to 

generate energy for change by doing things differently to support patient flow and 

improve patient experience, safety and staff morale. The scope was inpatient wards 

and Emergency Department supported by all the departments that serve these areas 

e.g. site team, discharge liaison team, therapies, information technology, facilities, 

MEMS, diagnostics, pharmacy etc. The underlining principle was „Right Bed, Right 

Patient‟ and staff supported in enabling a safe discharge to create the capacity and 

consequently improve patient flow. Ward Liaison Officers (non-clinical staff) were 

placed on the wards and were responsible for escalating issues with patient flow, 

patient experience (e.g. environmental issues) or affecting staffs ability to deliver 

excellent patient care. 

In terms of performance during the week, the expected outcomes were; 

Green escalation status 

Minimum 25 patients discharged and 50 declared discharges by noon. 

50% increase in direct admits to Ambulatory Care, Surgical Assessment Unit 

and 100% direct admits to the Acute Stroke Unit 

Emergency Department patients reviewed in 60 mins by senior clinician 

Maximum of 15 medical outliers 

Medical Day Case Unit and Cardiac Day Case unit out of escalation 

Reduction in staff moves 

Author: Helen Perkins, Senior EA to Chairman & Chief Executive 

Date: 20 th April 2013 

Document Approved by: James Scott, Chief Executive 

Version: One 

Agenda Item: 17 Page 1 of 5

0 electives cancelled due to bed capacity 

Reduction in concerns/incidents raised by Staff 

Reduction in number of complaints 

All of the above were achieved and some exceeded expectation, e.g. by Wednesday 

there were no outliers, every patient was placed in the right bed. For the first time in 

three months there were no new patient complaints. All wards were out of escalation 

on Monday morning and Medical Assessment Unit/Surgical Assessment Unit changed 

beds for trolley's to enable direct admits to once again go direct to wards, by-passing 

the Emergency Department. The biggest achievement was the 'can do' attitude of 

staff and the team effort that went into the week. The initiative would not have been so 

successful if it was not for the Ward Liaison and Departmental Liaison Officers that 

worked together to achieve the common purpose. The success of the event has also 

been recognised by the national Intensive Support Team who have commended the 

way the event was set up and run throughout the week. 

A report is being compiled on the outputs and lessons learnt from the event and will 

be brought to the June Board. 

2.3 Cancer Care Campaign 

Sir James and Lady Deirdre Dyson have generously donated £4m to the development 

of a pioneering new Cancer Centre at the Trust. The Forever Friends Appeal 

announced last year that it was starting its largest ever fundraising campaign, aiming 

to raise a minimum £5.5m towards the £20.5m cancer project, over the next three to 

four years. Following this donation the Appeal have almost all their initial minimum 

target secured and are able to extend their target for the Campaign, due to the 

excellent public support, to raise up to a further £3m. These additional facilities which 

will maximise the impact of the Centre‟s clinical care, are likely to include space for 

complementary therapies and educational activity linked to survivorship, a dedicated 

area for teenager and younger Adults, the use of art, pastoral gardens, the provision 

of state-of-the-art medical equipment and increased dedicated research facilities. 

2.4 NHS Complaints Review 

The Trust was contacted in mid-April by the Complaints Review Team at the 

Department of Health with a request from Ann Clwyd MP to visit the RUH to discuss 

the complaints handling process. Following the publication of the Francis report the 

government has asked Ann Clwyd to head up a review of complaints management 

across the NHS and as part of that process a number of visits are being carried out 

across the country to various organisations. 

The RUH were delighted to welcome Ann and her team on 22 nd April 2013 where they 

met with members of the Executive Team and the Patient Experience Team. In 

addition to this there were two ward visits, to Respiratory and Forrester Brown wards 

where the team were able to speak with the Ward Sister and Charge Nurse about the 

way that complaints and concerns are managed. Further discussions were had over 

lunch where a number of clinical staff met the review team. The Trust responded to a 

number of questions that the review team had and the information will be used as part 

of a final report being produced by the team. 

Author : Helen Perkins, Senior EA to Chairman & Chief Executive 



Version: 1 


2.5 Dr Foster Global Comparators Programme 

Dr Carol Peden, Associate Medical Director for Quality Improvement and Dr Louise 

Shaw, Consultant Stroke Physician, represented the RUH at the Dr Foster Global 

Comparators meeting in New York in April. 

The Global Comparators programme brings together more than 30 hospitals from 

around the world to share their data on HSMR, length of stay and readmission rates 

using the Dr Foster database and methodology. The aim of the programme is to drive 

improvement through collaboration and learning from high performers, within the 

domains of clinical effectiveness, patient satisfaction and cost. The RUH is very 

committed to the project with Dr Peden Chairing the Executive Board. The project has 

a number of “goal” work-streams, which are stroke, gastrointestinal (GI) surgery, heart 

failure and orthopaedics and trauma. Dr Shaw participated in the Stroke goal team 

meetings and Dr Peden in the GI surgery group. The general part of the meeting saw 

discussion of how hospitals worldwide analyse their mortality data. There was also a 

session on comparisons between the different health care systems with, for example, 

the UK having a significantly lower number of hospital beds per head of population 

than any of the other participating countries. 

The programme has had a relatively slow start with comparisons of data between the 

different health care systems proving much more difficult than anticipated because of 

the very diverse nature of the way hospitals are run around the world. The database 

provides a huge wealth of data and numerous quality improvement and research 

projects are now underway. The RUH is analysing the GI emergency surgery data, 

which fits with our interest in emergency general surgery. We are also putting together 

a project with the Business School at Bath University to learn from the international 

data on how to deliver a 24 hour a day, 7 day a week health service. 

2.6 Institute for Healthcare Improvement Visit 

The Institute for Healthcare Improvement (IHI) Fellows visited the Trust on 12 th and 

15 th April 2013 as part of their retreat before the International and US Quality 

Improvement Forum. 

Present at the visit, which was organised by Dr Carol Peden, Associate Medical 

Director for Quality Improvement and IHI Fellow, were Maureen Bisognano, Chief 

Executive of IHI, Professor Don Goldmann, Senior Harvard Professor and Head of 

Research at IHI and Jeff Sellberg, Chief Operating Officer of IHI. The programme for 

discussion during the retreat was varied with significant time spent on the Francis 

report. Professor Don Berwick, Emeritus President of IHI, is advising David Cameron 

on how to create a harm free NHS, and the Fellows spent a lot of time debating what 

advice they planned to give to Professor Berwick. 

During the course of their visit to the Trust, the Fellows met with members of the 

Executive Team as well as visiting the “Art at the Heart” team, Qulturum and Dyson 

Centre for Neonatal Care where they learnt about the quality and safety projects ongoing 

at the RUH. The Fellows felt the retreat was incredibly successful and would 

like to repeat the opportunity again in the future. 




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2.7 2013 Military and Civilian Health Partnership Awards 

Dr Richard Graham, Consultant Radiologist and Joint Clinical Lead for Radiology, has 

been shortlisted for a 2013 Military and Civilian Health Partnership Award in the 

Healthcare Reservist of the Year category which aims to promote and publicly 

recognise the efforts of health professionals from the public, private and voluntary 

sector(s) across the UK in providing care to service personnel, veterans and their 

families. 

Richard has recently returned from a tour of duty in Afghanistan where he was 

Consultant Radiologist and Radiology Clinical Director at the military hospital at Camp 

Bastion. He was an integral member of the trauma team delivering immediate imaging 

to severely injured troops and also providing general radiology to personnel working 

for the international security assistance force. This was Richard's second tour of duty 

in two and half years. 

Richard is also head of the Royal Naval Reserve Medical branch and leads the 

doctors and nurses nationally. He has also been involved in the strategy of the 

expansion of the reserve forces under the government's Future Reserves 2020 

project. 

2.8 NHS Foundation Trust Update 

As at 17 th May 2013, 6,244 public members have signed up to support the Trust‟s 

NHS Foundation Trust application. 

Our tenth Caring for You Event took place on 20 th May 2013; over 70 members 

attended the event to find out more about Stroke and the work that we do here at the 

RUH. Dr Louise Shaw and her team lead the interactive session; guests received two 

detailed presentations about Stroke and were then invited to have some refreshments 

and talk to the medical experts in more detail whilst having a look at some of the 

“information stations” that the department had created. The Stroke Association came 

along, and there were different information stands including Stroke research, speech 

and language therapy, brain scans and carotid imaging. 

2.9 Executive Director Appointments 

Following an interview process on 12 th April 2013, Helen Blanchard has been 

appointed to the post of Director of Nursing. Helen is currently Chief Nursing Officer at 

Worcestershire Acute Hospitals NHS Trust and will join the Trust on 27 th August 2013. 

Lynn Vaughan, Director of Human Resources, will be retiring from the RUH at the end 

of July. Lynn has been HR Director since July 2004 and has led the strategic 

response to workforce issues during a challenging period of the Trust‟s development. 

Krystyna Ruszkiewicz will join the Trust as Interim HR Director from Tuesday, 16th 

July 2013. Krystyna has extensive experience of working in similar posts within the 

NHS, having previously been Director of HR at the Royal Marsden and also at the 

Chelsea and Westminster Hospital. 




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Interviews for the substantive Director of Human Resources will be held on 2nd July 

2013. 

Following an interview process on 29 th April 2013, Julie Hill has been appointed as 

Trust Board Secretary. Jill is currently in the same position at Tavistock and Portman 

NHS Foundation Trust and will join the RUH on 1 st July 2013. Julie has also 

previously worked in both central Government and local Councils. 

2.10 Consultant Appointments 

Dr Lynn Diskin was appointed as a Consultant in Paediatrics with a particular 

responsibility for children with Diabetes on 8 th May 2013. Dr Diskin will join the Trust 

from Musgrove Park Hospital, Taunton where she is currently employed as a 

Specialist Registrar in General Paediatrics. Dr Diskin‟s start date is to be confirmed. 

3. Recommendations (Note, Approve, Discuss etc) 

The Board is asked to note the report. 

4. Care Quality Commission Outcomes (which apply) 

Not applicable 

5. Legal / Regulatory Implications (NHSLA / Value for Money Conclusion etc) 


6. NHS Constitution 

None identified 

7. Risk (Threats or opportunities link to risk on register etc) 

Strategic and environmental risks are considered by the Board on a regular basis and 

key items are reported through this report. 

8. Resources Implications (Financial / staffing) 


9. Equality and Diversity 


10. Communication 


11. References to previous reports 

The Chief Executive submits a report to every Trust Board meeting. 

12. Freedom of Information 

Public 




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Paper 17 - Royal United Hospital Bath NHS Trust

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